Brännström J, et al. - Researchers investigated the link between treatment with antidepressant medication and hip fracture in this population-based, matched cohort study of 408,144 individuals aged ≥ 65 years. According to findings, the presence of an association between antidepressant drug use and hip fracture before and after the initiation of therapy.

Methods

• Researchers individually matched 204,072 study participants enrolled in the Prescribed Drugs Register of Sweden’s National Board of Health and Welfare aged ≥ 65 years who had a prescription of antidepressants filled between July 1, 2006, and December 31, 2011, by birth year and sex to control participants who was not prescribed antidepressants.
• They collected outcome data was done from 1 year prior to 1 year after the index date (date of prescription being filled).
• They performed data analysis from July 1, 2005, to December 31, 2012.
• First filled prescription of an antidepressant drug was assessed as the exposure.
• They assessed incident hip fractures occurring in the year preceding and following initiation of antidepressant therapy as the main outcome.
• Multivariable conditional logistic regression models and flexible parametric models were used to investigate the associations.

Results

• In the year preceding and following initiation of therapy, more than twice as many hip fractures were noted among antidepressant users vs nonusers (2.8% vs 1.1% and 3.5% vs 1.3%, respectively, per actual incidence figures).
• Upon adjusted analyses, the investigators noted the highest odds ratios for the associations between antidepressant use and hip fracture 16-30 days before the prescription was filled (odds ratio, 5.76; 95% CI, 4.73-7.01).
• In all separate analyses of age groups, of men and women, and of individual antidepressants, they noted highest odds ratios 16 to 30 days before initiation of treatment, but did not identify any clear dose-response relationship.